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New Test Enables Diabetics to Detect Peripheral Neuropathy

The indicator plaster neuropad (IPN) is a new test that can be used by diabetic patients to identify peripheral neuropathy, according to a new published report in the February issue of Diabetes Care.

Dr. Nicholas Tentolouris from Athens University Medical School stated that, "The IPN can be performed by the patient at home in 10 minutes, and the result can be offered to the doctor in the next visit. "The test offers the opportunity to the patients to participate actively in the prevention of the devastating complications related to the diabetic foot problems."
Dr. Tentolouris and colleagues evaluated the interrater reliability between 156 patients and their healthcare providers for IPN in the diagnosis of peripheral neuropathy and the feasibility of using this test.

The IPN was previously shown to have a high sensitivity for the diagnosis of peripheral neuropathy and excellent reproducibility, the authors explain. The IPN turns a pink color when nerve conduction is normal and a blue color when peripheral neuropathy is present.

IPN had an 87% sensitivity and a 66% specificity for the diagnosis of peripheral neuropathy, the report indicates. Patients and health care providers agreed in 90.3% of the cases, deciding that the IPN results were normal or abnormal.
Patients consistently rated the IPN test instructions as easy to understand, easy to use, and easy to evaluate. About one fifth of the patients said they needed help performing the test.

"The results of the tests agree with those obtained by more complex tests used for the diagnosis of the diabetic neuropathy, including nerve conduction velocity studies, considered to be the ‘gold-standard’ method for the diagnosis," Dr. Tentolouris said.

"Currently there is no etiologic treatment for the diabetic peripheral neuropathy, and prevention of this complication with good metabolic control is the only available option," Dr. Tentolouris explained. "Therefore, patients with abnormal IPN test, that is patients with peripheral neuropathy, will be educated for the care of their feet, they will be instructed to use proper footwear, and they will have their feet examined by the healthcare professionals more often."

"According to the recommendations of the American Diabetes Association, diabetic patients without complications — including peripheral neuropathy — should be tested for the presence of complications yearly," Dr. Tentolouris added. His group recommends that patients with diabetes use the IPN once per year for the detection of peripheral neuropathy.

Diabetes Care 2008;31:236-237.